Improving children’s mental health in school settings in El Salvador

El Salvador's existing facilities are not equipped to meet the majority of students' mental health needs. The first National Mental Health Survey conducted by the Instituto Nacional de Salud (2022-2023), paints a troubling picture: a significant proportion of school children show signs of hyperactivity, emotional disorders, or behavioral problems (Jandres, Sandoval, Zelaya, et al., 2026). These disorders affect not only the students concerned, but also their classmates and teachers. According to a 2024 survey conducted by the Conscious Foundation with 185 teachers in northeastern El Salvador, one in five teachers felt their own mental well-being had suffered due to the classroom environment, where inattention, hyperactivity, and disruptive behavior are commonplace. Emotional and behavioral disorders are known to increase the risk for school dropout, poor academic performance, and long-term negative outcomes.

The Mente Amiga program has adopted an innovative approach by comparing two mental health support models in schools. Under the conventional method, trained professionals lead social and emotional learning (SEL) classes in schools, hold individual or group therapy sessions, and arrange meetings with parents. The alternative teacher-led model is potentially more accessible: classroom teachers are trained to deliver the same social and emotional learning content and provide informal support to vulnerable students, with weekly support sessions by a supervising psychologist and the option to refer students to mental health services. FID is financing both the implementation and evaluation of this program:

• 300 state primary schools across four departments of eastern El Salvador (La Unión, Morazán, San Miguel and Usulután) have been randomly assigned to three groups: 100 schools have psychologists, 100 have trained teachers, and the remaining 100 constitute the control group without any support.
• Data will be collected in three phases by an independent team. Five sets of indicators will be monitored: student behavior and mental health, academic performance, social dynamics, classroom atmosphere, and teacher mental health.
• The analysis will estimate the impact of each model and compare their cost-effectiveness. The team is working closely with the Salvadoran Ministry of Education, with the aim of preparing the project for future scale-up based on the study's findings.

The Mente Amiga project aims to demonstrate that structured mental health support in schools can improve student well-being and the learning environment over the long term, while being financially viable on a national level.
The project deliverables include:

• Measurable improvements in students' ability to regulate their emotions and behavior, their math and reading levels, and the quality of relationships with their peers.
• Less teacher burnout and a better atmosphere in the classroom at schools involved in the program.
• Conclusive data on the feasibility and effectiveness of the teacher-led model as a scalable alternative to the psychologist-based model. Over the long term, the lessons learned from the Mente Amiga project could inform the development of a national mental health program for schools in El Salvador and serve as a blueprint for other countries facing similar challenges.